左旋氨氯地平与氢氯噻嗪治疗原发性高血压并舒张性心力衰竭对比研究  

Comparative study of levamlodipine and hydrochlorothiazide on left ventricular diastolic function in patients with primary hypertension complicated with diastolic heart failure

作　　者：赵芳[1] 王杰敏[2] 杨秀花 王杰超[1] 卢旭东[1] 

机构地区：[1]河北省老年病医院普内科,河北石家庄050011 [2]河北师范大学财务处,河北石家庄050011 [3]河北省徐水县人民医院手术室,河北徐水072550

出　　处：《河北中医》2015年第9期1428-1431,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省二○一一年医学科学研究重点课题计划(编号:20110254)

摘　　要：目的观察左旋氨氯地平与氢氯噻嗪对原发性高血压并舒张性心力衰竭(DHF)左室舒张功能的影响。方法将61例原发性高血压并DHF患者随机分为2组。左旋氨氯地平组31例予左旋氨氯地平口服,氢氯噻嗪组30例予氢氯噻嗪口服。至血压达标并稳定1周后,观察2组患者血压、心电图、6 min步行距离、超声心动图[主要监测左室射血分数(LVEF)、左室舒张早期二尖瓣血流速度值(E峰)、舒张晚期二尖瓣血流速度峰值(A峰)、E/A比值及左室等容舒张时间(IVRT)],并与治疗后12周进行比较;观察2组心力衰竭缓解时间及ST-T改善情况。结果左旋氨氯地平组及氢氯噻嗪组治疗前后血压及心率无明显变化(P>0.05);治疗后2组6 min步行距离、LVEF、E/A均较本组治疗前提高,IVRT缩短,比较差异均有统计学意义(P<0.05),且2组组间比较差异有统计学意义(P<0.05);左旋氨氯地平组心力衰竭缓解时间较氢氯噻嗪组短,ST-T改善程度明显,比较差异均有统计学意义(P<0.05)。结论左旋氨氯地平较氢氯噻嗪能显著改善原发性高血压并DHF患者左室舒张功能。Objective To observe the effects of levamlodipine and hydrochlorothiazide （HCTZ） on left ven- tricular diastolic function in patients with primary hypertension complicated with diastolic heart failure （DHF）. Meth- ods 61 patients with hypertension complicated with DHF were randomly divided into two groups. 31 patients in le- vamlodipine group were treated by oral levamlodipine besylate tablets. 30 patients in HCTZ group were treated by oral hydrochlorothiazide tablets. The blood pressure, electrocardiogram （ECG）, 6 -minute walk distance, left ventricular e- jection fraction （LVEF） ,left ventricular early diastolic mitral valve blood flow meter （E peak）, late diastolic mitral valve blood flow meter （A peak）, E/A ratio and left ventricular isovolumetric relaxation time （IVRT） were observed in two groups one week after patients achieved optimal blood pressure, and compared with those in 12 weeks after treatment. The heart failure relief time and the ST - T improvement were observed in two groups. Results There ere no statistical significance between two groups on blood pressure and heart rate before and after treatment （ P 〉 0.05 ）. The 6 - minute walk distance, LVEF and E/A ratio after treatment were increased in two groups （P 〈 0.05 ）, the IVRT was decreased （ P 〈 0.05 ）, and there was statistical significance between two groups （ P 〈 0.05 ）. The heart failure relief time in levamlodipine group was shorter than that in HCTZ group, and the improvement of ST - T in levamlodipine group was more obviously, there was significant difference between two groups （P 〈 0.05 ）. Conclu-sion As compared with HCTZ, levamlodipine can better improve the heart function in patients with primary hypertension complicated with DHF.

关 键 词：高血压 心力衰竭 心舒期 心室功能 超声心动描记术 氨氯地平 氢氯噻嗪 

分 类 号：R541.61[医药卫生—心血管疾病] R544.110.5[医药卫生—内科学]